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Wearing Flip-Flops? Watch Your Step

They're everywhere when the weather turns warm, but a podiatrist warns flip-flops carry more risks than blisters and stubbed toes.

Dr. Rock Positano, the director of the Non-surgical Foot and Ankle Service at the Hospital for Special Surgery in New York City, says the risk is not that people wear flip-flops -- it's how they wear them.

"I have no objection when patients say, '... What is the best way to wear these type of shoes?' I always say, 'Look, use your head -- if you're hanging out by the swimming pool or hanging out on the beach, they really cause no damage or no problem,'" Positano tells NPR's Michele Norris. "When people develop problems is when they wear them in an unusual situation -- such as 5-mile hikes or standing on their feet for 5 to 10 hours on a trip."

Positano says that's when he sees tendinitis, heel problems, Achilles tendon issues, ankle injuries -- as well as injuries in other parts of the body.

"Unfortunately, these shoes have no significant orthopedic support for the foot and the ankle. And of course, as Leonardo da Vinci taught us, the foot and ankle is the most important part of the body cause it makes contact with the body first. If the shock is not absorbed appropriately from the ground -- it gets transmitted to other parts of the body. So what'll happen -- it'll start as a foot issue, and then it will go to the lower leg, the hip, the knee, the back," he says.

Positano also says beware of wearing flip-flops in areas where there might be a higher concentration of pathogens or bacteria.

"We see that particularly in Central Park," he says. "I had a patient a few years ago that developed one of the nastiest, nastiest skin infections I've ever seen -- required the person to be on antibiotics for almost two months. And the reason being was that this was a person that was wearing an exposed shoe."

"I prefer a thicker one, because it's more rigid. And of course the rigidity gives the person a little bit more support, which means they have better capability for shock absorbing. And people also ask this question: 'The cave man used to walk [on] bare feet.' I say, 'Yeah, but the problem is the cave man only lived to 20 years old.' I mean, people are living a lot longer lives these days and you need to be able to protect your feet from an earlier onset. Because clearly the problems you have now are only going to get worse as a person ages."